374604063-10-27-2021-08-AS-DPOL-C8A344-20211029175429

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604063
Report Date: 10/27/2021
Date Signed: 10/27/2021 01:07:33 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/23/2021 and conducted by Evaluator Liliana Silveira

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20210323150144

FACILITY NAME:	MESAVIEW SENIOR ASSISTED LIVING		FACILITY NUMBER:	374604063
ADMINISTRATOR:	GENOVEVA GUERRERO		FACILITY TYPE:	740
ADDRESS:	7971 CULOWEE STREET		TELEPHONE:	(619) 466-0253
CITY:	LA MESA	STATE: CA	ZIP CODE:	91942
CAPACITY:	30	CENSUS: 28	DATE:	10/27/2021
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Licensee, Jeffrey Settineri		TIME COMPLETED:	11:10 AM

ALLEGATION(S):

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Lack of supervision resulted in elopement.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Liliana Silveira conducted a complaint investigation visit to deliver findings for the above allegation. LPA Silveira met with Licensee Jeffrey Settineri and Administrator Genoveva Guerrero and shared the findings.

The Department’s investigation consisted of interviews, records review and observations. On 03/23/21, it was alleged that a resident (R1), wandered from the facility two days in a row and was found by police who returned her home. During an interview with the Administrator, it was disclosed that R1 resided at MesaView Senior Independent Living, located at 7908 La Mesa Blvd, La Mesa, CA 91942, an address different from Mesaview Senior Assisted Living, which is located at 7971 Cullowee St., La Mesa, CA. 91942. Mesaview Senior Assisted Living is licensed by Community Care Licensing Division (CCLD).

A review of CCLD systems revealed that Mesaview Senior Independent Living is not licensed by Department of Social Services (DSS) and therefore does not fall under CCLD's jurisdiction. Records review confirmed that R1 signed an Independent Living Residency Agreement with MesaView Senior Independent Living for a private apartment (CONTINUED OF PAGE 2).

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (610) 301-9770
LICENSING EVALUATOR NAME: Liliana Silveira	TELEPHONE: (619) 314-0756
LICENSING EVALUATOR SIGNATURE:	DATE: 10/27/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20210323150144

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: MESAVIEW SENIOR ASSISTED LIVING	FACILITY NUMBER: 374604063
	VISIT DATE: 10/27/2021

NARRATIVE

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LPA also conducted a tour of the facility and observed that a fence separates the two properties. There are also two separate signs indicating that one property is independent living and the other property is assisted living. LPA also observed that residents from the independent apartments do not commingle with residents from the assisted living facility.

Based on the evidence obtained from the complaint investigation, the allegation that lack of supervision resulted in elopement is found to be UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

An exit interview was conducted and a copy of this report and Licensee's Rights (9058 01/16) were provided to Administrator Genoveva Guerrero, whose signature on this form confirms receipt of these documents.

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (610) 301-9770
LICENSING EVALUATOR NAME: Liliana Silveira	TELEPHONE: (619) 314-0756
LICENSING EVALUATOR SIGNATURE:	DATE: 10/27/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2021

LIC9099 (FAS) - (06/04)

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